Do nurses ever truly clock out?


Ahhhh… Vacation.  Gotta love it.  Nurses tend to joke around about never truly being on vacation.  We make t-shirts about it, send each other funny memes, laugh about it at work.  But really, we do tend to try to avert anything that looks like it might turn into an emergency, because hey, everyone needs a mental break sometimes.  Even nurses. That being said, we also jump in and help without hesitating if the need arises.  Even on vacation.

Last weekend I met up with a girlfriend of mine for a weekend away from home.  We met in St. Louis, which makes the most sense for us while trying to meet halfway.  (I live in Oklahoma, she lives in Ohio.)  We had an awesome weekend just catching up, trying some new restaurants, seeing some great sites and places.  We even managed to get in on opening night of Miss Saigon.  I did not manage to get away from being a nurse for the weekend, however.

We were hiking up the concrete steps of the Gateway Arch when it happened.   I was blazing a trail to the bathroom (which seemed a good half mile off in the distance) when I hear my friend call my name.  I turn around and see her.  One of the sweet little elderly ladies we had just talked to is lying on the ground, clutching her head, groaning softly, a grimace on her face.  My friend later told me “her head sounded like a melon cracking open” when she hit the ground.  She has fallen down the concrete steps onto the equally hard concrete pavement below and taken a direct hit to the back of her head.  My friend motions me over, saying “You gotta help”, and I’m doing a split minute decision on whether my bladder will hold out for this emergency, or if it will become the main emergency itself.  I can’t NOT help her though, so I rush back to her side.  I gently address the elderly group surrounding her– “I’m a nurse, may I help you?”  The look of relief is evident on their faces.  I quickly assess her while someone goes for help.  She hasn’t passed out, and she is talking to me without difficulty, so I know she is okay for the moment.  Soon a physical therapist stops and offers help, and bystanders are quick to help with whatever they can–keeping her shaded from the bright sun shining in her eyes, something to put under her head to pillow it from the concrete ground,  etc.    Her friends are praying out loud, panicky, scared something terrible has happened.  My training kicks in–regardless of what has happened, calm the patient and those around her.  I quickly point out to her and her friends that she is stable for the moment, and that emergency services will be here shortly for further assessment and to take her to the hospital.  I talk directly with the patient then, discussing her condition and telling her what needs further testing and why.  She insists she doesn’t want to slow down her group of friends, which has not yet gone up in the Arch.  I gently remind her that she might have suffered a brain bleed from the fall, which wouldn’t necessarily be obvious in the few minutes that have passed.  At the very least, she might very well have a concussion.  I convince her to keep from moving until Emergency Services get there to take over.  Once they arrive, I step back and let them do their thing.  We leave after they have taken over and have things well in hand.  I still really need to use the restroom, and it’s almost time for our tour to go up the Arch.  For all I know, that elderly group of visitors may have been slated to go up on the same tour as us.  We’ll never know; neither will we ever know how things turned out for her.  We did ask a park ranger after the tour if they had any updates.  Apparently, she was still refusing further medical care and was not taken to the hospital.  I laid awake that night, worried for her.  Was she okay? Did she eventually get worse as time went on? Was she near help if she did worsen?  As I lay there, I thought of all the things I could have done differently to help her.  Did I miss something? Was there anything else I could have done before EMS arrived? And other thoughts I had…Why are the steps and walkway designed like they are at the Arch? How many people fall on them each year?  How much worse are they when it’s actually wet?  How do they respond to emergencies inside the Arch? Or at the top? How far is it to the nearest hospital?  Where DID those emergency workers come from so quick? Why aren’t there better signs posted around the Arch, directing traffic?  Sometimes I have a hard time shutting down the “what if” questions. 

Nurses are trained to look at scenarios to find out what’s wrong and to try to fix it.  I guess that’s something you don’t just turn off when you clock out and walk out the door.  I had a great weekend in St. Louis, but I came away with a few golden nuggets of wisdom.  1) Allow plenty of time to reach your destination, in case something unexpected happens.  2) Never turn down a bathroom break when it’s presented to you, as you may really, really wish you would’ve taken it a little while later.  3) Always be prepared to lend a helping hand to those around you…you’ll be so glad you did.  

To the sweet little lady who fell, I hope you are okay.  I hope you and your friends were able to go see the Arch.  I hope your vacation was all you dreamed of.  And… here’s to many, many more adventures for the both of us. 

                   Nurse Ames, RN

ladyat arch


“Who is my neighbour?”

“Be the reason someone smiles today.” –source unknown

Here’s to all the good Samaritans out there. To those who always go out of their way to help when they see someone in need. To those who pitch in in times of disaster, whether it be at the local, state, or national level. To those who stop to help someone cross the street or to help change a flat tire. To those who babysit for the tired single mother who has reached her limit, or to those who stand in line at the blood bank during shortages. You know who you hat’s off to you!  

Here’s the deal. I try to be that person. That all-American, next-door neighbour kind of gal. I think it’s my nature, I am a nurse of 25+years after all. In fact, I took an oath when I became a nurse, right? But even nurses, who are inherently compassionate, sometimes miss the obvious. Sometimes we rush through life like everyone else and miss an opportunity to lend a helping hand. Sometimes we just want to make it to that appointment on time, or actually take our full 30-minute lunch break, or get home to our waiting families. But that’s never a good excuse, and I know it.
About a week ago, a high-school buddy of mine from out-of-state texted me that he was in town because his dad was in the hospital. Wanted to know if I was working the weekend and if I would be his dad’s nurse. And to please swing by to say “Hi” if I could. It wasn’t until I got to work and chatted with him and several of the other nurses that I realised how sick his dad was. My fellow nurses were telling me things like “We weren’t sure if he’d make it that first hour or two in the ER.”, and “We didn’t think he’d pull through that first night.” Ok, so I’ve written about the upside of living and working as a nurse in a small-town community. This is definitely the downside–when you watch the gradual decline of friends and neighbours, or their family members. My friend’s dad, John*, had recently been hospitalised for pneumonia and his stay was much longer than it was last year. And now he’s back in the hospital with a much worse case of pneumonia. And here’s the part where I’m kicking myself (as well as a 40-something year old nurse can do so). I might have been able to prevent it. In fact, I think with a sinking feeling in the pit of my stomach, I am pretty sure I could have helped this situation from escalating to this point. A couple of weeks ago, I had seen John in the hospital cafeteria eating lunch. Being an elderly single 85-year-old, he doesn’t cook for himself and often goes out to eat with his other older buddies, or by himself if necessary. This particular day, I had seen him in the cafeteria while quickly grabbing my own lunch. I was shocked at how much more frail he looked than when we had discharged him the month before. He was breathing slightly faster than normal, and his overall appearance spoke of decline. I debated over and over in my mind…Do I respect his privacy and assume he will take the necessary steps to care for himself? Do I text his son(my high school friend) and tell him he needs to make an appointment for his dad with his doctor? Independence is one of the last valuable gifts we cling to as we age–do I respect that for John, assuming if he gets worse that someone else closer to him will step in and help? Is it rude to go up to someone and tell them they look horrible and need to be seen by a doctor? Is it breaking HIPPA if I send a message to his son, since he’s technically not a patient at this point? I quickly ponder all this as I make my run through the cafeteria, my mind halfway on the patients waiting for me back in ER. And then I’m back in the thick of things, and I have no more time to think about it until later that evening when my shift is over.

We are all faced with decisions like this every day. Do we chance being the nosy neighbour or meddling family member? Is our help truly needed or can that need be met by someone else closer to the problem? Am I enabling someone with my help? Or giving them a hand up? We all have to decide how we will respond to those in need around us. And what might seem like a huge need or concern to us may not even be important to the person actually dealing with the problem. Obviously, hindsight is 20/20, and I wish like crazy I could go back in time and text my friend that day that his dad appeared to need medical attention. Or, I wish I would’ve taken the time to stop and say, “Hey, John, come by the ER when you’re done eating lunch–we’d be happy to take a look at you and make sure you’re okay.” Instead, I rushed through my day rather than take the time to divert my attention to a friend in need. I feel terrible. We all screw up from time to time, and I’m gonna add this one to my list of “could’ve-should’ve-would’ves”. My instincts failed me this time, and it is not a good feeling. So, moral of the story, my friends–always trust your gut. If it’s telling you to intervene, take the time to do whatever is necessary to help. You’ll feel so much better about it, and who knows? It might even save a life. Thankfully, I can report that John is making headway on beating this newest round of pneumonia. He is planning on moving into an assisted living facility after his hospital stay, as he has no family around here to care for him. His son will oversee his care from several states away. And I will personally make sure I check on him as often as I can. Again, it’s the “Do unto others as you’d have them do unto you” rule. And this time I plan to get it right, to be that good neighbour/friend. For who is my neighbour? Besides the obvious ones living next door, it’s those around me in need, those who cannot care for themselves, those who need a helping hand. One thing in life is for sure, there’s always more opportunities to help, always another occasion to give a friend a helping hand. You might not make it to that appointment on time, or get your 30-minute lunch, but you’ll be able to sleep in peace at night, knowing you did the right thing. So here’s to being the good Samaritan, the good neighbour. You’ll be glad you did.

*name changed for privacy